r instance, at least thirty per cent. of the abdominal wounds were
complicated by wound of the thorax; and in the lower segment of the
abdomen injury to the extra-peritoneal portions of the pelvic organs was
common.

Both the immediate and ultimate prognosis were influenced greatly by
this fact.

As to the individual injuries:

1. Wounds in the intestinal area, except in certain directions, often
traverse the abdomen without inflicting a perforating injury on the
bowel.

2. If the alimentary canal is perforated, injuries in certain segments,
even if perforating, may be followed by spontaneous recovery. I should
say the prognosis from this point of view is best in the ascending
colon, then in the rectum; after these most favourable segments, I
should place the others in the following order: stomach, sigmoid
flexure, descending colon. As to perforating wounds of the transverse
colon and small intestine, I believe spontaneous recovery to be very
rare.

3. Wounds of the solid viscera generally, usually heal spontaneously,
and give no trouble unless one of the great vessels has been injured. I
include in this category all organs except the pancreas, of wounds of
which I had no experience.

4. Wounds of the bladder, if of the nature of pure perforations in the
intra-peritoneal segment, often heal spontaneously.

5. As a rule, injuries to the organs in their intra-peritoneal course
have a far better prognosis than those which implicate the organs in
their uncovered portions.

6. The small calibre of the bullet is alone responsible for the
favourable results observed.

7. The danger or otherwise of an intestinal injury depends mainly on
mechanical conditions; for instance, the fixity of the ascending colon,
and its comparative freedom from a covering of small intestine capable
by movement of diffusing any infective material, account chiefly for
such favourable results as are seen when that segment of the bowel is
implicated.

WOUNDS OF THE EXTERNAL GENITAL ORGANS

Wounds of the _scrotum_ were not uncommon, especially in connection with
perforations of the upper part of the thigh. They offered no special
feature, beyond the common tendency of every-day experience to the
development of extensive ecchymosis.

Wounds of the _testicles_ I saw on several occasions. I remember only
one out of some half-dozen in which castration became necessary. I was
told of one case, for the accuracy of which I cannot vouch, in wh